• Journal of Chest Surgery
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• v.36 no.1
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• pp.15-20
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• 2003

Myasthenia gravis is a rare autoimmune disease involving acetylcholine receptor and its autoantibody on neuromuscular junction. The methods of treatment are medical treatment and surgical thymectomy. In this paper we analyzed the result of thymectomy and the factors affecting the postoperative symptom improvement. Material and method : This study obtained medical records of 37 patients who received the thymectomy for myasthenia gravis from March 1986 to December 1998. Result Out of 37 cases, 21 cases(57%) showed improvement, of which 8 cases (50%) in the group of thymoma(n=16), and 13 cases (62%) in the group of thymic hyperplasia(n=21) showed the improvement of symptoms. Postoperative complications were respiratory insufficiency due to aggravation of symptoms after operation, including tracheal intubation for ventilator support in 9 cases, pneumonia in 3 cases, pneumothorax in 2 cases and left vocal cord palsy in 1 case. There was one postoperative mortality. The relation between postoperative improvement and sex(P=0.3222), age(P=0.7642), thymic pathologic variants,(P=0.4335) and classification of thymoma(P=0.20) showed no statistically significant correlation. However, the lower grade of preoperative symptoms can predict the lower grade of postoperative symptoms significantly(P=0.0032). Follow up study to 36 postoperative survivors was performed in October 2002 based on the out-patient records and call with patients. Out of 36 cases, 33 cases(91.7%) could be investigated and 3 cases could not. Mean follow up period was 83.2 months. Out of 33 cases, 25 cases(75.8%) showed symptomatic improvement, of which 8 cases(53.3%) in the group of thymoma(n=15) and 17 cases(94.4%) in the group of thymic hyperplasia(n=18) showed the improvement of$\boxUl$ symptoms. Conclusion : In myasthenia gravis, thymectomy showed the good improvement, and more important factor affecting the improvement of symptoms was the grdae of preoperative symptoms. Also midterm and long term follow up results showed good symptomatic improvement.

• Journal of Veterinary Clinics
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• v.23 no.4
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• pp.465-468
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• 2006

A 3-year-old, spayed female Shih-tzu dog was presented due to acute vomiting, diarrhea, and generalized weakness. The dog had generalized weakness, increased respiratory rate, and respiratory muscle effect. Neurologic examination revealed appendicular muscular weakness and decreased in tone of the anal sphincter. Megaesophagus was confirmed by radiographic examinations. Other than type 2 fiber atrophy, no specific abnormalities were identified in histopathologic examinations of muscle biopsies from the left pelvic limb. Serum acetylcholine receptor (AChR) antibody titer was increased (0.78 nmol/L reference range, less than 0.6 nmol/L), confirming a diagnosis of acute fulminating myasthenia gravis. The dog dramatically responded to pyridostigmine bromide and had marked improvement in muscle strength, megaesophagus, and respiratory function. The dog has been successfully managed for 7 months after initial treatment.

• Journal of Yeungnam Medical Science
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• v.17 no.2
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• pp.129-136
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• 2000

Background and Purpose: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. Material and Methods: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). Results: There were statistical differences of decremental response($mean{\pm}SD$) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response($mean{\pm}SD$) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. Conclusions: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.

• Journal of Yeungnam Medical Science
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• v.15 no.1
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• pp.125-134
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• 1998

Purpose: This study was undertaken to evaluate the clinical usefulness of Tensilon test, repetitive nerve stimulation test(RNST), single fiber EMG(SFEMG) test and acetylcholine receptor antibody(AchR Ab) assay for making diagnosis of myasthenia gravis(MG). Method: These tests were performed in 21 MG patients which were classified into 11 ocular, 5 mild generalized, 4 moderate generalized, and 1 chronic severe MG. Result: The overall positivity of Tensilon test, SFEMG and AchR Ab was 95%, 87%, and 76% respectively. The overall positivity of RNST was 67%; 38% on flexor carpi ulnaris, 43% on adductor digiti quinti and 62% on orbicularis oculi muscles. The positivity of each test was higher in generalized MG group than in ocular MG group. But we could observe the statistically significant difference only in the RNST(p<0.05). Conclusion: Tensilon test showed the highest positivity in all MG groups. So we would like to recommend the, Tensilon test for the diagnosis of MG at first, followed by RNST and AchR Ab assay, and SFEMG would be indicated to MG group which showed relatively low postivity in other tests.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.85-89
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• 2019

Objectives : The purpose of this study was to quantitatively assess the degree of myasthenia gravis (MG) affecting mental health through the results of multiphasic military personality inventory in late adolescence. Methods : We collected and analyzed the results of the military personality inventory for healthy controls and MG patients among the 19-year-old men who visited the Military Manpower Administration from February 2007 to January 2010. Military personality inventory invented for Korean military test has similar system to Minnesota multiphasic personality inventory. Results : Among validity scales, each score of faking good, faking bad and infrequency subscales showed no difference between healthy control and MG groups, respectively (t=-0.51, p=0.607 ; t=0.11, p=0.913 ; t=1.41, p=0.158). Among neurosis scales, the score of somatization subscale was higher (t=2.29, p=0.023) in MG group. Among psychopath scales, the score of schizophrenia subscale was lower in MG group (t=-2.38, p=0.018). Conclusions : According to MPI results, we can confirm that MG patients in late adolescence may be more concerned with their somatic symptoms than the control group, and that they may be more likely to abide by the regulation and be conventional in their behavior than the control group.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.277-286
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• 2001

Background: This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. Materials and Methods: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. Results: The significant electrodecremental response of RNST were noted in orbicularis oculi(58.9%), nasalis (51.3%), flexor carpi ulnaris(42%), anconeus(41%) and abductor digiti quinti muscles(27%). Among the 3 muscles of upper extremity(abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles(p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. Conclusion: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1516-1522
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• 1992

Thirty patients with myasthenis gravis[MG] underwent transternal extended thymectomy between 1983 and 1992 in Pusan National University Hospital. The age of patients was 11 to 62 years[mean; 35.2 years] with female dominant[M: F=l: 4]. According to modified Osserman classification, group I was in 6, II A in 7, II B in 13, III in 2, IV in 2 patients respectively. Their clinical response to thymectomy was evaluated. The follow-up period ranged from 2 months to 9.5 years[average; 51.3 months]. Fourteen patients[13.3%] had remission and eleven[43.3%] were improved after operation; half of patients were benefited from operation. Twenty patients had thymic hyperplasia and seven had non-infiltrating thymoma. In thymomatous MG one patient had remission and five were improved. Postoperative death was in a female patient. The cause of death was respiratory failure in the severe generalized MG preoperatively.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2009.10a
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• pp.207-207
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• 2009

• Journal of Chest Surgery
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• v.54 no.4
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• pp.310-313
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• 2021

There are several types of minimally invasive approaches for thymectomy, of which the transpleural approach by video-assisted thoracoscopic surgery is particularly useful. In this approach, thymectomy is performed from either side of the thoracic cage. Thoracic surgeons should be familiar with the principles of the procedure, the anatomy of the region, and surgical strategies for successful thymectomy. The details of transpleural thymectomy are discussed herein.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.100-100
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• 2021